[Vaginal cesarean for fetal deaths in utero]

Among a series of 100 cases of retroplacental hematomas we performed vaginal cesareans in 15 and present here the technical difficulties, solutions and indications of this procedure in case of in utero fetal death. Criteria for choosing vaginal cesarean were: term les than 32 weeks, biparietal diameter > 80 mm, fetal weight < 2500 g. The main difficulty was the disproportion between the size of the fetus and the cervical orifice due to insufficient anterior trachelotomy. Possible solutions are posterior trachelotomy or craniotomy. This procedure is rapid and causes little blood loss and important advantage in case of impaired hemostasis.